颅中窝-侧颅底沟通性恶性肿瘤的手术治疗

目的 探讨颅中窝．侧颅底沟通性晚期恶性肿瘤的手术治疗方法。方法 16例颅中窝-侧颅底沟通性恶性肿瘤分别采用了：①耳后“C”形切口,颞骨次全切除进路与高位颈侧切开联合进路行颅中窝-侧颅底和腮腺区肿瘤切除6例;②颞侧舌形切口,颅中窝进路颅内外肿瘤切除4例;③颞-耳-下颌骨外旋进路行咽旁、颞下窝、颅中窝肿瘤切除6例。其中13例术后进行放射治疗。结果 16例中11例术后存活3年以上,5例术后3年内死亡。按寿命表法统计,3年生存率为69％。结论 本组所采用的三种手术方式,能较好地暴露颅内外病变,并进行肿瘤切除。对颅底区晚期恶性肿瘤采用手术及术后放射治疗等积极措施可取得一定的治疗效果。

Surgical treatment of transcranial middle cranial fossa-lateral skull base malignant tumor]

OBJECTIVE: To evaluate the surgical method of transcranial middle cranial fossa-lateral skull base malignant tumor. METHODS: Sixteen patients with transcranial middle cranial fossa-lateral skull base malignant tumors were treated by three surgical methods. (1) Postauricular "C" form incision, combined with subtotal resection of temporal bone and high lateral neck approach to resect tumors located in middle cranial fossa, lateral skull base, and parotid region. (2) Temporal side "tungue" form incision, middle cranial fossa approach to resect tumors inside and outside the skull. (3) Temporal-auricular-mandible swing approach to resect tumors in parapharyngeal-infratemporal fossa-middle cranial fossa. Thirteen of the 16 cases received radiotherapy postoperatively. RESULTS: After operation, 11 of the 16 cases survived more than three years, five cases died within three years. Three-year-survival rate was 69%. CONCLUSIONS: Our results showed that the three surgical methods adopted could fully expose the internal and external skull lesion to remove the extensive malignant tumors. For late stage malignant tumors of the skull base, it should be treated aggressively by combination of surgical therapy and postoperative radiotherapy.